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20100131
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medicare's future. when families are scraping to pay their medical bills, fraud, waste and abuse in our healthcare system are simply unacceptable. so today the president has asked us to put criminals on notice. the attorney general and i have convened this unprecedented summit featuring leaders from the public and private healthcare sectors because we believe the problem with healthcare fraud is even bigger than government, law enforcement or the private industry can handle alone. we'll need all of us working together to solve it. in the fight to prevent, find, catch and prosecute the crooks, we want every good idea we can get. everyone here has something to offer because healthcare fraud is a national problem. it affects federal programs like medicare, state programs like medicaid and private insurance companies. we're all vulnerable because we're all part of a healthcare system that's undergoing rapid growth. between 1970 and today, america's annual healthcare spending has gone from $75 million to over $2.5 billion. that's produced significant benefits for patients but it's also creat
in social security and medicare. cuts in social security an medicare. i would simply say to them, look at where we are. look at where we are. social security and medicare are both cash negative today. the trustees of medicare say that medicare will go broke in eight years. social security will take somewhat longer. but both are on a path to insolvency if we fail to act. mr. president, it hasn't just been from the more liberal side of the spectrum that the criticism has come. also on the right. "the wall street journal," ran this editorial calling the debt reduction commission or the deficit commission a trap. they say it is a trap that will lead to higher taxes, to more revenue. so on the left and the right we have those complaining that if you move forward to deal with the debt, you're going to make reductions in programs and you're goi i think that's undeniably the case. if you're going to deal with this debt threat, we are going to have to make changes in the spending prowewewewewe are goine changes in the revenue base of the country. i would suggest for those who are concerned abou
. in 2002 under the employee initiative the centers for medicare and medicaid services began publicly reporting quality information on nursing-home nationally on their web site. this was followed a year later by a similar effort in the home health arena. simultaneously there have been demonstration products by medicare in home house and skilled nursing facilities. state medicaid agencies have begun experimenting with a for performance in the nursing-home setting. the question is how these current market-based reforms address these broad goals of long-term care. in theory these reforms are perfectly compatible with these goals of improving quality of life and reducing fragmentation and increasing community-based services but there are several key attributes of these market-based reforms that may limit their effectiveness in this regard. the first limitation is current market-based reforms tend to rely on narrowly defined clinical quality measures. this tends to reinforce a medical model of care which pays more attention to clinical quality than issues related to quality of life and a c
but clearly with a body in medicare 55 and older you're going to pick up two or 3 million more. now you've got the program operated by opm. you will have a body in there of probably 7 million people. there's a provision most haven't focused on which is the state can set up a separate program for people, government-run, between 133% of poverty and 300% of poverty. i know a number of states will essentially do that and then finally, in all probability the exchanges are going to be run by states. so as the system comes forward you've got a bigger medicare and bigger medicaid that fixed rates, other components which are going to have negotiating rates. the bad news it's going to take four or five years to get this up and operating so i'm not sure there's going to be a lot of changes. but we have to start thinking how we bring this together. it may well be medicare and medicaid are dictating rates for the other groups that in fact negotiate. >> if we take that is the presumption we are going to see something, bill, i would like you to respond to what we are talking about here. but there's also the
the expansion includes higher taxes, includes medicare cuts. it also at the end of the day, according to the congressional budget office, does very little for most people in this country to actually reduce the cost of their health care insurance. in fact, what we've seen through the studies that have been done by the c.b.o., the congressional budget office, by the c.m.s. actuary is for most americans they are going to see at best their health insurance premiums stay the same and if you're in the market, go up. the health care bill is an example of this runaway federal spending. in the latter part of that debate, we got a response from the c.b.o. to a question that was posed by the senator from alabama, senator sessions, with regard to how the accounting is done on medicare. because one of the arguments that we heard throughout the course of the debate is that it would extend the life span of medicare. in fact, when the c.b.o., the the question was posed of them: what happens with this additional medicare tax and these medicare cuts that would be imposed upon providers and on senior ci
's developed and directed a number of national programs, including the center for medicare education, the better jobs, better care national program, funded by the robert wood johnson foundation and atlantic philanthropy. she was a political appointee during the clinton administration, serving in the u.s. department of health and human services as deputy assistant secretary for disability, aging and long-term care policy. she also was assistant secretary for aging in 1997. she's been a senior researcher at the national center for health services research, and at project hope center for health healthy communities fares previously, as well as -- health affairs previously, as well as at georgetown university. to begin, let's welcome to the podium, steven kay. >> some people focus on specific federal programs, or they might focus on quality issues or work force issues or family care giving, and they also tend to focus on specific population, such as the so-called frail elderly, on non-elderly people with disabilities or cognitive disabilities. as carol levine said in her article in this i
%, the medicare payroll tax. that's a job killer. so there's a relationship between job creation and taxes, economic activity and, therefore, revenues to the federal treasury and tax rates. tax rates and taxes are not the same thing. you can reduce tax rates and actually collect more taxes. again, it sounds paradoxical, but it's true. think of this when you go to the store before christmas and they slash their prices by 40%. they're not doing that to go out of business. they're still making money. they're making more money on the volume that increases because a lot more people coming into the store even though they reduced the cost of each of the items than they would if they increased the cost of each of the items. i guarantee if they raised their prices before christmas, their competitors would reduce their prices. not to make less money, they would get more people in, make more volume. and make more money. when you -- so i'm very reluctant to support a commission which i believe will undertake to reduce our deficit by raising tax rates. it's not good for job creation. it's not good for
to pay for its medicare expansion and my state didn't? james q. wilson also wrote in his essay that respect for the law of unintended consequences is -- quote -- "not an argument for doing nothing but it is one," mr. wilson said," for doing things experimentally. try your idea out in one place and see what happens before you inflict it on the whole country," he suggests. well, if you'll examine the "congressional record," you'll find that republican senators have been following mr. wilson's advice, proposing a step-by-step approach to confronting our nation's challenging -- challenges 173 different times during 2009. may i say that again. republican senators during 2009 173 different times on the floor of the senate have proposed a step-by-step approach toward health care and other of our nation's challenges. on health care, for example, we first suggested setting a clear goal. that is, reducing costs. then we proposed the first six steps toward achieving that goal. number one, allowing small businesses to pool their resources to purchase health plans. number two, reducing junk
, what are entitlements? medicare, social security, veterans benefits, things that cannot be controlled that if you're entitled to them, you get them. and you look at interest on the debt is what -- is 5%. if you look at discretionary defense, it's 18%. and if you look at everything else the federal government does that everybody talks about: education, agriculture, justice, education, the 22 departments in homeland security, it is just 16% of what is spent. so if you add together the 50% and the 5% of interest, you see 55% of everything the federal government spends this year cannot -- cannot be controlled. you have to spend it. and so all the rest that's discretionary is rather small in comparison. if you project that out ten years -- and i must tell you, new numbers are coming out tomorrow, so this is the latest number that i have -- entitlements go up to 56% and interest on the debt to 14%. so that is 70% of everything that is spent in the year 2019 if things are projected forward cannot be controlled. discretionary defense is 16% and nondiscretionary -- again, everything else -- 14
, too, is an entitlement. we tend to think about social security and medicare, medicaid as being the entitlements of great concern to us. interest on the national debt is truly obligatory, it has to be paid, it's an entitlement in the strongest sense of the word. our witnesses last week suggested we need some target thes. we don't need to be out there doing ad hoc things, we need some target to shoot at, and they were suggesting we try to bring the deficit down to 3% of gdp and bring the debt or at least hold it to no more than 6% of gdp. are those reasonable goals? do you think they're too level, too high, too tight, too strict? >> so, again, mr. chairman, it's not our place at cbo to suggest what your goals should be. economists don't have any analytic basis for saying, this is the crucial point in terms of debts or deficits. it is true that as we push in this country to 60%gdp at the end of this year and beyond that over the next few years, we're moving into territory that most developed countries stay out of. we are moving into territory the that is unusual in our historical
or not the government should take over 1/of our economy, slash medicare by half a trillion dollars, raise taxes by half a trillion dollars and drive insurance rates up for the most of the rest of our country and i think we heard a large and resounding message yesterday if one of the most, if not arguably the most liberal states in america. the people of massachusetts spoke and spoke loudly. one concern i know a imin of you had about the outcome of this election would be whether the new senator would be seated. i'm convinced now that no gamesmanship will be played by the other side with regard to future votes in the senate. senator jim webb, made it clear he will not participate in any additional health care votes prior to senator brown being sworn in. and i noticed that elected officials in massachusetts who were principally responsible for certifying election after earlier saying take up to two weeks, indicated it could be as soon today. i don't believe the kind of thing we've seen on full diswith the corn husbander kick back, the louis purchase, the gator aide, drafting the bill behind closed doors,
like social security and medicare. but it was a proposal that both republicans and democrats, i hoped, would like enough to move forward. the spending problem we have, mr. president, is like a cancer, and this chamber refuses to seek any treatment. and while i did not like the proposal completely, i at least supported it because i knew we needed to do something. our spending is out of control. we have a $12 trillion debt. the deficit of last year was was $1.4 trillion, more than the past four years in the bush administration combined. now, i am new to this chamber, so the bizarre still seems bizarre to me, and perhaps the longer you're here, bizarre starts to seem normal. but we cannot spend more than we take in. we cannot continue to amass a debt that our children are going to have to pay for. right now, we have to go borrow money from countries like china because we can no longer raid social security and medicare because those programs now need those dollars to be paid out. but at some point, this country is going to have to pay the piper. at some point, we're going to have to drama
and medicare and medicaid were all attacked in their own time as the end of america's way of life. and are now for the most part a cherished part of the social fabric of america. and it remains because in massachusetts, the state that has already adopted a similar healthcare program, not even the republican senate candidate who voted for the massachusetts plan would speak against it. this year we will also work hard to enact legislation to build our energy independence. and create clean energy jobs. we'll push for final passage of wall street reform to bring accountability back to our financial sector. that bill would protect americans from some of the most abusive practices that led to the economic crisis. keep taxpayers off the hook for future bailouts. to the too big to fail firm and safeguard our entire economy from another collapse brought on by wall street's most reckless gambles. energy legislation and regulatory reform are both powerful actions on behalf of working families. it goes without saying that in the majority -- if the majority ruled in the senate, america would be closer to e
in washington on massachusetts. cutting half a trillion dollars from medicare you're going to look at longer lines, lesser coverage. we know we need to reform pricing as a member going to be doing very shortly. but do you think were going to have a one-size-fits-all plan in congress is going to come down here in massachusetts and hurt what we have here at that's one of the differences between martha coakley and i peered were talking about a trillion dollar health care plan, have a trillion dollars of medicare cuts at a time when we just don't need it. i would propose actually going and allowing the state to do it individually with a government incentive i senate. very similar to what he did here. we can actually export out and show them how to do it. i'm looking for to having the opportunity to be the 41st about and make sure that we get that plan back to the drawing board. >> ms. coakley? >> thank you, david. thanks for hosting us this evening. how would be proud to be the 60th vote to make sure we get health care reform that we so badly need. we've taken a major massachusetts and getting e
are, elderly, or late middle-aged because of the pattern of our wars. most will qualify for medicare anyway. the va has excess capacity. it soon will have a whole lot more excess capacity. as the last the world war ii generation and korea war pass along. . . dicare is about two-thirds. so this is a triple winner. open up the va to the vets who can use the medicare entitlement not only that, open >> let them buy into the system. does not only makes clinical sense, an 80 year-old veterans, they're both going to have to learn to take care of each other, but it makes financial sense because every person you get off medicare into the va, you save may be about a third. and patient satisfaction is incredibly high. so that's my case. for what we've got to do, not just about agent orange situation, but getting our veterans ride in general. thank you. [applause] >> well, thank you everyone for your remarks. i want to open it up to questions from the audience. at first i just want to ask a few myself. and the first is, that it seems like both in vietnam and in the united states, this is sort of
the medicare s.g.r. payment system for physicians and for other purposes. h.r. 4154, an act to amend the internal revenue code of 1986 to repeal the new carrier overbasis rules in order to prevent tax increases, and so forth and for other purposes. mr. reid: mr. president, i would object to further proceedings in respect to these two bills. the presiding officer: objection having been heard, the bills will be placed on the calendar. mr. reid: mr. president, visiting with nevadans as i have done during these past several weeks, it's impossible not to be motivated to get back to the business of legislating. it's impossible to ignore their grief over growing foreclosures, the uncertainty of unemployment, and the frustration of fighting insurance companies for your family's health, and it's just as evident that the people of nevada and the nation need us to work toward sensible solutions rather than drown once again in the partisan bickering that consumed much of last year. some elections go your way. some elections go the other way. it's the nature of democratic politics in a very diver
there with social security and medicare, and we are meeting with the members on every, at the caucus and different groups of the caucus to add here to halladay receive the best way to go, how they would prefer to go forward. but, we will go forward. so with that i would be pleased to take any questions. >> the message from massachusetts seems to be they want to go into more, voters want to go in a more moderate directions. are you going to make any effort to tell republicans their welcome at the table and you think they would come? >> they are always welcome at the table. we have a responsibility always to find common ground. the number of hearings that were held to write these bills in three committees practically, one-third of congress and the house participated in those hearings in a bipartisan way and in many cases some of those republican amendments were adopted, but they had made it clear that they are not for health care reform, and we are coming in so to the extent we can find common ground between those two differences is, remains to be seen but always welcome. the message from massachuse
to driven and consumer -- driven patients entered health care. we should be looking at the medicare trust fund and the pressures that on how that trust fund. the ballooning costs of medicaid. if we move to a public auction. as a move into the health care reform or even from my state the lessons should have been learned from tenor who care which was the test case for hillary clinton care in '94, my states still has this, it is the greatest public health failure in the country. that would be a great opportunity for us to look at what is affecting us with health care. certainly there are more pressing issues fell. we are appreciative of your time to be before us today in fall we all are concerned with leaching chemicals that come from plastics into bottled water, we are, indeed, very concerned with what we see what has suppressed during evidence from a speech to employees and are concerned with what we've seen, health care issues that are affecting all of our constituents and a lack of willingness to address those in in a patient's center consumer driven manner and i yield back my time. >> t
in the last several years has far acceded the -- exceeded the growth of medicare and social security and it's crowding out our ability to fund medicare and social security t.'s a threat to those programs as well as the long-term fiscal status of our country. finally, i would just point out, madam president, that i just left a budget committee hearing, and mr. elmendorf, the c.b.o. director, testified this number today and indicated to us that if several more things that probably are likely to occur, occur -- which he did not use in his calculations the number here would be much worse, much higher. he says we are facing a critical economically threatening force of debt that we have got to do better about. and so did chairman conrad and so did ranking member gregg in their opening statements. i would point out that he reaffirmed their score that under the present path we are on, we now pay in 2009, $170 billion per year in interest. that's what we pay on people who loaned us money. the public debt. by 2019, ten years, that debt will triple from $5.7 trillion to over $17 trillion. and the inte
. king stale, and the federal employees health benefits program. the advantage program, medicare part b systems of switzerland and other lands, arguably also germany also contains many elements of an exchange. the health alliances and around which the clinton health plan was bills were exchanges appear, as were in our state base and private purchasing cooperatives which have been tried repeatedly and sometimes with success over the past two decades. connecticut business and industry association represented here today one represents a successful private purchasing cooperative. of course, while each of these models can be called an exchange, they are, in fact, quite different. indeed, the models represented by the house and senate bills are different in very significant ways. the focus of my paper and of my brief presentation this morning is on how the house and senate bills differ and on which model is most likely to result in the exchange spenser's past the goals that an exchange is intended to fulfill. first, quickly let me ask the question, why do we need exchange? what do we expected
of the provisions. the closing of the donut hole. that is how much people on medicare have to pay out-of-pocket for their medication. we want to close that gap, so people don't have to pay that much. we do it in the house of representatives. so that was the think a lot of the conversation, so it is not sip yet. was do we covered a town hall meeting with congress to packin michigan. you talk a lot about his amendment on abortion, part of the house legislation. did that come up plus side and what is the fate of that abortion language? >> guest: it did. the pro-choice caucus, which i am part of, which has well over 100 members in the house of representatives, and wide support certainly throughout the country for reproductive health care being part of any package. it came up last night in the context of those of us who are pro-choice, believe that we ought to stick with the status quo, which says and i want to say it very clearly, not any federal dollars to pay for abortions. we don't necessarily like that but we agree with that. that is the hyde amendment. and the stupack amendment, and
. if they had been a distinction made because of the volume of potential medicare recipients or poverty levels or something involving health care and nebraska that was different, then that would be a different story on the constitutionality. that's why many states in the national legislation are not all treated the same because they are distinctions. and a lot of times there's a lot of straightening that goes on as we all know. but there is always a reason given. well, there is no reason given here except the one i recited and that is one that we see as unconstitutional and is likely seen by many as a symbol of the excesses of the corruption and excessive spending and fiscal irresponsibility in the congress. now that is not addressed in this letter. with this letter addresses is simply the constitutionality of that one provision. after we wrote the letter the next day which was thursday, december 31st, i received a telephone call from senator gramm saying he had received a telephone call from senator ben nelson asking to call the dogs off, and senator gramm suggested to senator nelson that he
and his republican allies in congress designed a medicare prescription drug benefit, they did so without offsetting at all the hundreds of billions of dollars in new spending. indeed, they even larded it up with special deals for the pharmaceutical industry. in other words, the republicans relied entirely on deficit spending to fund a huge new entitlement program. that was the way they actually did business. the republicans lethe republicay on deficit spending to fund a new entitlement program. that is the fact. now republicans inaccurately -- and frankly hypocritically -- rail on budgetary grounds against our efforts to extend health care coverage. but unlike their costly prescription drug bill, our health care bill improves our budget baseline. the baseline we inherited from president bush desperately needs improvement. this next chart shows the deterioration of annual deficits under the previous administration. the facts are plain. george bush vastly increased spending while cutting tax revenues. the structural deficit that he built in and left to president obama simply cannot be sust
of financial fraud cases from mortgage fraud to medicare, and health care fraud to securities fraud, to corporate malfeasance. i'm proud that we have put in place a law enforcement response to the financial crisis, that is and will continue to be aggressive, comprehensive, and well coordinated. while the reach of our investigative and prosecutorial function is broad, we do not purport to have all the answers. as a general matter, we do not have the expertise, nor is it part of our mission to opine on the systemic causes of the financial crisis. rather, the justice department's resources are focused on investigating, and prosecuting crime. it is within this context that i am pleased to offer my testimony and contribute to your vital review. the department has a long history of prosecuting financial fraud, an we will continue to do so. working in concert with our federal, state, local, tribal and territorial partners, the justice department is using every tool at our disposal, including new resources, advanced technologies, and communications capabilities, and the very best talent tha
. that is an entitlement and we tend to think about social security and medicare and medicaid as being the entitlements of great concern to us. the national debt is obligatory and has to be a case, it's an entitlement in a strong sense of the word. our witnesses last we suggested we need targets, we don't need to do ad hoc thing is a lease for the intermediate and long run but we need targets to shoot at and they were suggesting we should try to bring the deficit down 23% of gdp and. the data or and least told it to no more than 60% of gdp. are those reasonable goals? to do you think there are too high or too tight or too strict? >> so i can mr. chairman it's not our place at cbo to suggest what your goal should be. economists don't have a analytic basis for saying this is the crucial point. in terms of debt or deficits. it is true that as we push in this country to 60% of its gdp this. beyond that over the next few years removing into territory that most developed countries stay out of it. we are moving into territory that is unusual in our historical experience and the experience of other countries
boomers are going to retire, and the cost of social security and medicare is going to skyrocket. these are promises we have to keep to seniors because they pay for it, but we have no idea of how we're going to keep those promises to seniors right now, particularly in light of the current economic situation. as we look at where we are, we need to recognize how we got there. and as i've talked to banks, businesses, foreign financial ministers from europe who have come here, everyone agrees that there are two major causes of the economic problems here and around the world. and one is the high leverage or the high borrowing that went on because of the loose monetary policy at the federal reserve. easy money, cheap money encouraged companies and individuals to borrow more than they could afford to pay back because it was easy to get and cheap. the big banks on wall street could more easily borrow money than to raise capital. those were incentives created by the policies at the federal reserve. the second problem is what we are calling toxic assets, which are securitized subprime mort
forward, not backwards. >> but just look backward for medicare. [laughter] >> just for you, just for you. look, i think there was a moment in time where disney stock was $20 a share. because i ultimately i am a finance major. i start a little bit from the business perspective. obviously you have to love the strategic perspective. espn has been a terrific business. business channel, then done incredible things. family channel was once a really bad deal. now looks like a great channel. disney is firing wonderfully. we were right after 2001 theme park attendance was at a low. there was a shareholder revolt going on. there was the founding family say we want change. there was a vote coming up, and somehow, right or wrong, there was discussion between parties involved with both companies on a back channel basis that said, maybe now that you've done a at&t, you'd like to come in and put our two companies together. we openly throughout that idea. they said no thank you. and pretty quickly we said, we are not in the business to go in and completely disrupt and over pay and stock today's 30, up f
of uncertainty. 500 billion in medicare cuts. over 100 some taxes americans for tax reform group estimates. new regulations. penalties. people are actually looking into the health care reform legislation is constitutional. if it doesn't violate proscription against excessive fines and punishment you can go to jail or pay a huge find for not having this kind of a program. all of these are very legitimate concerns people are -- security taken to their members, security and affordability. people talk about security. it is also national security. it can be national security and health security and security of certainty. affordability, that can be taxes debt, deficits, could be housing, college tuition. could be just basic cost of living and quality of life. that could be entrepreneurship. kitchen table economics. wall street, main street. all has to do with affordability. what we're hearing for voters going into 2010. much has been talked about with respect to new democratic retirements and ones that i think are imminent as wells and how will that bode well for republicans? it may, i actually think
has exposure to medicaid, medicare, and other costs and is finding ways over perhaps not even elite but over a number of years to bring down the cost per person health care. i have not read the cbo study. i know enough to know that health care economists have differed quite a bit about implications of different proposals and different measures. so i'm not going to weigh in with a number. i don't have a good number to give you. only to repeat what i've said before, which is as part of this process, it's very, very important that we do our best, not to reduce the quality of care or reduce coverage or to make health care worse here this is a very inefficient system and there must be ways to reduce the cost of delivering that health care, and there have been many ideas suggested, ranging from information technology, to various incentive payments, to experimental or evidence-based medicine. i just want to reiterate that because it is critical that we get a stable and sustainable fiscal trajectory going forward, we do need to address this issue. and i don't think we can get a sustainable
stamps, and medicare are examples of those more federal uniform policies. if a program or policy is he developed at a time when there is a major goal to reduce the role of the federal government or the size of the federal government, which was true in the 1980's, the goal is to devolve decision-making and administration from the federal level down to lower levels. and then you wind up getting policies like the current welfare system, the temporary assistance for needy families, and workforce development. if on the other hand, program or policies being developed by congress at the national level at a time when there's distrust of state and local government, but more trust in the federal government, perhaps like in the 60's during the war on poverty, then you may see more federal control of programs, but devolution down to the local level. community action agencies, public health centers are examples of those. the depending on when a policy or program is enacted in congress, the philosophies, the values that are dominant at that particular time heavily influence the structure of the prog
girls, who genuinely feels there will be no social security for him, that medicare may not be there either, and he understands that the global competition facing his generation and his daughters' generation is greater than at any other time in our nation's history. the global competition is greater than at any other time in this nation's history, and that the burden that we have created because of our fiscal irresponsibility brings into question whether his children will enjoy the same opportunity for a standard of living that we have had. mr. president, i said in the beginning of my speech i believe the issues this amendment is designed to address, our national debt and deficits as far as the eye can see, can two of the most important issues congress and our nation face. our failure to address these issues will damage our economy, our nation's security, peace in the world, and the kind of future that we leave to our children and grandchildren. mr. president, the future of our nation is in our hands. the future of our nation is in the hands of these 100 senators here, a
Search Results 0 to 31 of about 32 (some duplicates have been removed)